Representative Deshotel has filed a bill which mandates that surveyors treat nursing facility staff with courtesy during inspections. It reads specifically:Sec. 242.0447. DUTIES OF REPRESENTATIVES. The department shall adopt written policies requiring representatives of the department to treat the residents of an institution and the institution's staff with courtesy, consideration, and respect during an inspection, survey, or investigation conducted under Section 242.043 or 242.044 or in … [Read more...] about Ms. Manners For Surveyors
Resident Choice of Pharmacy vs. Facility Choice of Medication Distribution System
Do you use a pharmacy that has adopted the Opus system or a similar system? Have you specified that any pharmacy who does business with your facility must use the Opus system including the part where the pharmacist generates the MARS and physician order forms and provides other services?If so, you may run afoul of DADS. Recently, a facility was cited for having such requirements on the basis that this is a violation of resident rights. As you know Rule 19.1502, Choice of Pharmacy states: A … [Read more...] about Resident Choice of Pharmacy vs. Facility Choice of Medication Distribution System
They’re After Aleve Now
Doubtless, you've all heard the news about Vioxx and Celebrex and the allegation that those drugs increase the risk of heart attack or stroke. Now an Alzheimer's Prevention Study is being halted because Aleve, one of the medications they are using in the study, contains naproxen, the same ingredient contained in Celebrex. The subjects of the study were being administered Aleve, Celebrex or a placebo. I cringe to imagine of the activity going on in offices of plaintiff's personal injury lawyers … [Read more...] about They’re After Aleve Now
“Who’s on First?” regarding Employee Misconduct Registry Appeals at APS
The State reorganization was bound to cause some confusion as agencies reformat and try to fill in the gaps forgotten by the Legislature. We've had occasion to look into the issue of what is going to happen to the appeals that concern placement of an employee on the Employment Misconduct Registery. It appears that these appeals are in limbo right now.Our sources at some of the agencies tell us that Department of Family Protective Services does not want to hear these appeals itself. It wants … [Read more...] about “Who’s on First?” regarding Employee Misconduct Registry Appeals at APS
Double Penalties
If you have a pending nursing home Civil Penalty case based on a survey that predates September 1, 2003 and you have already paid a Federal Civil Monetary penalty, the Fort Worth Court of Appeals has rendered a favorable decision. The case is The State of Texas v. Haltom Medical Investors, L.L.C. d/b/a Haltom Convalescent Center.The facts of the case involve a survey done in July, 2002 which resulted in a recommendation of Federal Civil Money Penalties and a referral to the Texas Attorney … [Read more...] about Double Penalties
Adjusting To The Medicare Drug Prescription Plan
The Robert Pear from the New York Times has published a piece opining that confusion will be caused by the fact that the Medicare Drug Prescription Plan may cause confusion for nursing home residents as a result of the fact that residents will be allowed to choose between two or more government subsidized plans. The article states:The premise of the law is that Medicare beneficiaries will carefully compare these plans and enroll in the ones that best meet their needs.But more than one-third of … [Read more...] about Adjusting To The Medicare Drug Prescription Plan
Will Work For Laws
Sometimes when doing presentations for health providers, I joke about over-regulation of health care by asking that before participants decide to suggest new laws-- they close their eyes and imagine hordes of lawyers running through the Halls of Congress holding cardboard signs that say: Will Work For Laws. I may be joking but the reality of over-regulation is directly addressed by physician blogger Dr. Bob at The Doctor Is In who says:When last I checked several years ago, Medicare had about … [Read more...] about Will Work For Laws
Pitfalls of Pain Management
You all know that Pain Management is a quality of care concern for DADS. Facilities have been cited for failing to adequately and systemically deal with pain being suffered by residents.Nursing facilities must, of course, obtain physician's orders for pain medication and increasing dosages and types of medications. Today, there was a column in the New York Times by Sally Satel regarding the criminal liability risks assumed by physicians who are managing pain with narcotics.(You may need to … [Read more...] about Pitfalls of Pain Management
Written Statements for Incident Reports
Lately, several people have asked me about the advisability of having employees write statements to accompany reports of incidents sent to DADS. It is my position that having your employees write such statements is neither advisable or required.Thus, the next question is--how do you conduct your investigation if you don't have your employees write statements? My answer is that your investigator actually investigates. That means interrogating employees who are witnesses to an incident or who may … [Read more...] about Written Statements for Incident Reports
Criminal Checks of Nursing Home Residents?
On November 15, 2004, CBS news reported on an incident involving alleged resident-on- resident sexual abuse in a Florida nursing home. The resident-suspect, a man in his 80's, had been found wandering the streets by Florida law enforcement. A Florida court declared him a "vulnerable adult ... in need of protective services." Thus, the officials caused him to be admitted to the nursing home--where he allegedly sexually abused another resident.Buried further down in the story, it is noted that … [Read more...] about Criminal Checks of Nursing Home Residents?